Anemia of Chronic Disease

(Anemia of Inflammation; Hypoferremia of Inflammatory Disease; ACD)

Definition

Certain long term medical conditions, such as cancer and infectious and inflammatory diseases can cause anemia. Anemia is a low level of healthy red blood cells (RBCs). RBCs carry oxygen from the lungs to the rest of the body. When red blood cells are low, the body does not get enough oxygen. This can cause symptoms such as fatigue, pale skin, or irregular heartbeat.

Causes

Certain illnesses will prompt your body to limit how much iron is freely available. This will prevent the infection or cancer from using the iron to grow. Unfortunately, iron is also needed to make healthy RBCs. Over time, this will lead to fewer new red blood cells.

Treatment

With ACD, if the underlying disease causing it is found and treated, the anemia may improve or clear on its own. Iron supplements and vitamins are generally not effective.

For severe cases of ACD,
blood transfusions
may be necessary. Another treatment is to give erythropoiesis-stimulating agents (ESAs), which help stimulate growth of new red blood cells. These drugs do have risks that are important to consider before using them. There is some evidence that ESAs may shorten survival in cancer patients.

Prevention

If you have a chronic medical condition, continue prescribed treatment and maintain regular visits with your doctor.

RESOURCES

Iron Disorders Institute
http://www.irondisorders.org

National Heart, Lung, and Blood Institute
http://www.nhlbi.nih.gov

CANADIAN RESOURCES

Canadian Cancer Society
http://www.cancer.ca

Health Canada
http://www.hc-sc.gc.ca

References

Beutler E. Unlocking the mysteries of iron homeostasis and of the anemia of chronic disease: is hepcidin the key?
Blood. 2003;102:775.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.